Prescription rechecks at the Pricing Authority

Prescription rechecks at the Pricing Authority

PSNC strongly recommends that pharmacy contractors review every FP34 Schedule of Payment and check for possible problems – whether they are due to pharmacy staff or Pricing Authority error. Our Using Your Schedule of Payment to Monitor Performance page can help you identify what to look out for.

If pricing concerns are identified, contractors should contact the Pricing Authority via the Help Desk on 0300 330 1349 to discuss their payments or consider requesting a recheck.

How to request rechecks

To request a recheck from the Pricing Authority, contractors are required to:

Submit their request within 18 months from the end of the dispensing month being requested (e.g. for prescriptions dispensed in January 2016, a contractor must submit their request for a check by 31 July 2017).*

Complete a separate form for each month being requested for a recheck. Contractors with more than one pharmacy need to complete separate request forms for each pharmacy and month they wish to have checked.

Indicate the type of recheck they require (e.g. number of items, expensive items, switching) – see tick boxes shown in the picture opposite.

Pharmacy contractors should be aware that where they have requested rechecks of one or more complete monthly bundle(s), the Pricing Authority has advised that it will select an equivalent number of additional months to check to ensure that adjustments made fairly reflect both underpayments and overpayments.

Where a net underpayment is revealed, the contractor will be paid the value of the underpayment;

Where a net overpayment is revealed, the Pricing Authority will recover the value of the overpayment.

*Please note: Once the 18-month deadline for requesting a check has passed, no further requests can be made for that particular dispensing month.

Guidance on interpreting letters received following rechecks

The letters sent from the Pricing Authority following a request for a recheck currently document the number of forms and items counted during the recheck, but only limited details regarding errors and adjustments. The Pricing Authority staff will talk through further details on checks by telephone if they are contacted. The Pricing Authority has reviewed the level of feedback which they give to contractors following their checks and are now providing details on the most common errors found in the batch so that the contractor can adjust their processes to prevent them from occurring.

The following may assist in clarifying the details on the breakdown of errors and amounts provided by the Pricing Authority in their letters to contractors.

When accounts are checked and as a result, there are adjustments to be made to the account, these can be broadly split into the following categories:

Drugs credit/debit: This is the net adjustment taking into account drug costs and payments for containers (‘split pack fees’) for items wrongly priced, missed (i.e. not priced at all initially) or priced in error.

Fees credit/debit: This is a net adjustment in relation to single activity fees, expensive item fees and prescription charges. Again, such adjustments may be necessary in the case of accounts where there have been items wrongly priced, missed (i.e. not priced at all initially) or not dispensed (ND) items priced in error as well as for prescriptions that have been ‘switched’ in error or conversely not switched during the initial pricing but should have been.

The F-Code or ODS code is the the unique code issued to your pharmacy which identifies you to NHS Prescription Services. You can find this on any pricing authority statement or your prescription submission document (FP34c).